Re-Biopsy after SVR

[newleaf09]

I just got the results of my post-TX biopsy.  Re-biopsy is not typically recommended but I have plans to move away from good health care and needed verification that I will be safe.  I was biopsied and started TX as a genotype 1 in November 2008.  The '08 biopsy was very bad; grade 3 inflammation, stage 4 fibrosis.  The pathologist called it 'probable or incipient cirrhosis'.  Scared me to death!  I went through a very rough 28 week TX and am still not recovered from it.  My doctor recommended that I wait one full year after the end of TX (June 1).  Here are the new results: Grade 1, Stage 2-3.

I had hoped for 2 stages of regression and then got scared of being overly optimistic and jinxing myself.  The doctor was astounded, I am astounded.  I asked if, since the biopsy was done so soon after TX, he thought I would continue to heal and he did not have an answer because it's so rare for SVR patients to re-biopsy and there's just nothing to compare to.  He thinks more regression is likely.  I also asked him if I could stop worrying about liver cancer and he cautiously said that he thought so, that he thought HCC, the type of liver cancer we HCV patients worry about, was highly associated with both cirrhosis and HCV together and since I had lost both I was probably safe now.  Not for sure, but 'probably' is good enough for me.  

This may be my last post on the forum.  When I get the hard copy of the biopsy report, I'm thinking of adding it to my inch-thick file and burning the whole thing.  It's over.  Happy, happy, happy.

[Isobella]

Great news!!  I'm so happy for you!!!

I say copy the file and then burn =)

All the best,

Isobella

[willing]

very, very, good news - being able to put all this into past tense really is the goal here isn't it? Thanks for posting the bx update , a  rare data point as you point out, and for everything you've contributed here. You'll be missed!.

There's something to be said for the health benefits of a worry-free life, but I'd recommend continuing the occasional US scans. Occurrence of hcc, with hcv as the primary risk factor but without cirrhosis, is rarer but not nonexistent:

"The average annual risk of HCC in patients with cirrhosis from HCV is 3.2% (13). The annual risk in Japan is approximately 6% to 7% (14). Among patients without cirrhosis, the annual risk increases as the stage of fibrosis increases (F0 or F1 [none or minimal portal fibrosis] = 0; F2 [periportal fibrosis] = 1.5%; F3 [bridging fibrosis] = 5.1%) (15)"

from (free access)
"Hepatocellular carcinoma: management of an increasingly common problem."
http://www.ncbi.nlm.nih.gov/pubmed/18628926

[newleaf09]

Thanks to all for well wishes.  I really posted to let others know that the information floating around about regression of fibrosis is true & I, for one, can verify it.  I'll be carrying the re-biopsy report to all my non-GI doctors who still believe that cirrhosis is irreversible and a death sentence.  I took a lot of encouragement from Dr. Shiffman's HALT-C presentation this year, which said that 10% of cirrhotics can go all the way back to zero damage in 4-5 years after SVR.  Hope I make it.  It's quite an emotional recharge to go from fearing doom to knowing that an essential internal organ is remaking itself all shiney new.  I'm liking it.

[JennyPenny2009]

Hi there. Congrats on the great news. I had a talk with Dr Shiffman about improvement in histology scores when he biopsied my friend who was in the HALT C trials. She was Stage 4, cleared, and had her biopsy 7 years post treatment. She went from a Stage 4 to a Stage 0-1. He told us that the liver continues to improve for quite a number of years. I am very happy for you.

[nygirl7]

That is absolutely fantastic news newleaf I am very happy for you - stage 2/3 means you did great.

I wish you the best of luck in where ever you and go and whatever you do. You've been a tremendous asset on the forum and I am sure everyone wishes you well in life.

[ArthursMom]

Great News!!!  Thanks for sharing it. This is one crazy disease that we (some of us) have! The best to you in the future!